Student Registration Form - Virtual Persian Academy

This form must be completed by the parents / carers before the child attend Virtual Persian Academy. No child will be accepted without a completed Registration Form.
In order to keep records up to date and accurate we require parents / carers to complete a new form each September, at the start of the academic year.
It is the responsibility of the Head Teacher to review these forms and to pass on any pertinent information to all other staff and volunteers regarding the child’s health and behaviour requirements.

Child’s First Name *

Child’s Last Name *

Please write "Child’s First Name" and " Child’s Last Name" to Farsi Language *

Names of any siblings attending this Supplementary Academy

Date of Birth *

Your Home Full Address (Street, Town, Postcode) *

Name of Mother / Main Carer *

Daytime Mother Phone No *

Email of Mother *

Mobile of Mother *

Name of Father / Main Carer *

Daytime Father Phone No *

Email of Father *

Mobile of Father *

Emergency Contact name *

Phone number *

Relationship to child *

Do you have book for the class? *

Please give details of any issues (e.g. health problems, emotional, learning difficulties or any other problems.

Is there anything else you would like to tell us before your child starts the School?

Do you give permission for video or photographs to be taken of your child (for publicity purpose only)? *

User Email *

User Password *

Confirm Password *

I AGREE *

I agree that the above details are correct and up-to-date and that if any of the details change, I will inform the School.

I've read and accept the PRIVACY POLICY.

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